Over its long history, hormone replacement therapy for women in menopause has been the Jekyll and Hyde of medications. It has careened from savior to villain, from cure-all for every female complaint to poison. And when in 2002, the National Institutes of Health-funded, $1-billion Women’s Health Initiative loudly announced that women taking HRT had an increased risk of breast cancer, its role as “savior” all but disappeared. Other dire alleged consequences included heart disease, stroke, dementia and even “all-cause mortality.”

Understandably, millions of women panicked, along with much of the medical establishment, and dropped the option of hormone therapy altogether. (Estrogen is given by itself to women who have had hysterectomies and, as HRT, in combination with progesterone to those who still have a uterus.)

The good news about estrogen has been lost: namely that more than 70 years of findings from animal studies, human studies, observational studies and randomized controlled studies demonstrate the benefits of estrogen. Most remarkably, the research shows the failure of the accepted hypothesis that estrogen causes breast cancer. In fact, estrogen has been successfully used as a treatment for women with the disease, and, remarkably, it can often be safely administered to most women who have had breast cancer.

Women on hormone replacement therapy live, on average, several years longer than those not taking it.

Heart disease, not cancer, is the leading cause of death for women in every decade of their lives (it is even the leading cause of death for breast cancer survivors). Hormone replacement therapy can decrease that risk by 30% to 50%. It can also cut in half the risk of osteoporotic hip fracture — a crucial benefit because as many older women die annually after breaking a hip as die of breast cancer. And numerous animal and human studies indicate that estrogen is the only intervention that prevents or reduces the risk of Alzheimer’s disease and other forms of dementia in women.

HRT is the most effective treatment for familiar menopausal symptoms, including hot flashes, night sweats, insomnia, vaginal dryness and loss of sexual desire, and for the less familiar symptoms: heart palpitations, joint and muscle aches, headaches, bladder problems and depression. Forget the black cohosh and chaste tree; they are no better than placebos.

Finally, because of estrogen’s benefits for heart, brain and bones, women on hormone replacement therapy live, on average, several years longer than those not taking it. This is one reason that the North American Menopause Society and 30 other international groups concluded that “there are no data to support routine discontinuation [of HRT] in women age 65 years.”

The 1920s weren’t just gin joints and jazz. Anti-immigrant racism was all the rage.

By Lisa McGirrJan. 16, 2019

On Jan. 16, 1919, Nebraska became the 36th state to ratify the 18th Amendment to the Constitution, which banned the manufacture, sale, import or transportation of intoxicating liquors. The Prohibition era had begun.

Prohibition looms large in the national imagination even today as the era of gangsters and gin joints. Less often do we reflect on what motivated the country to adopt it and maintain it for 14 years. While the country faced a real problem of excessive drinking, powerful anti-immigrant hostility is what drove this monumental act of constitutional overreach.

Today, as we find ourselves in the midst of another fight over immigration, it is worth revisiting the role that nativism played in driving, and later enforcing, Prohibition. The consequences of that battle reverberated for decades to come. It sparked a vast expansion of the repressive capacities of the federal government and a rise of right-wing extremism, led by a revived Ku Klux Klan. It also forged a new political coalition that would bring ethnic working-class voters into the Democratic Party, where they would remain for much of the century.

Temperance and Prohibition had been popular causes throughout the 19th century, but supporters didn’t reach a critical mass until the era of mass immigration at the turn of the century. With more than a million men and women coming to the United States in 1907 alone, anti-liquor crusaders railed against a “foreign invasion of undeveloped races.” The boisterous drinking culture of the ubiquitous working-class saloon, dominated by immigrant men, seemed to make manifest the dangers mass immigration posed to a white native Protestant American way of life.

During World War I, the Anti-Saloon League, the self-declared Protestant Church in action, fanned nativist flames: With the large brewing companies in the hands of German immigrants, the league declared the abolition of “the un-American,” “home wrecking, treasonable liquor traffic” the most patriotic act. Congress concurred, sending the 18th Amendment to the states on Dec. 22, 1917.

Ratification sped through the states in record time, stunning its ecstatic supporters: “The rain of tears is over. … Hell will be forever for rent,” the flamboyant evangelical preacher Billy Sunday proclaimed. The Woman’s Christian Temperance Union, the powerful grass-roots female reform organization at the core of the anti-liquor crusade, raised an American flag at its campaign headquarters in Evanston, Ill. Church bells rang at many Protestant churches in celebration of “Uncle Sam’s knockout blow … that set John Barleycorn and all his cohorts to the mat.”

The utopian hopes of Billy Sunday and his ilk that the 18th Amendment would turn “our prisons into factories” quickly evaporated. The vast and powerful federal agencies in charge of policing Prohibition as of January, 1920, along with state and local enforcement, overcrowded court dockets, changed legal doctrine and flooded prisons, but they did little to meet Prohibitionists’ almost impossible ambitions.

Newly hired and poorly trained Prohibition agents, along with local and state police, targeted violators at the margins, but they lacked the capacity, and at times the will, to go after powerful crime kingpins. Chicago’s Al Capone, Ohio’s George Remus, New York’s Arnold Rothstein and Seattle’s Roy Olmstead amassed large fortunes in the profitable illicit drink trade, oiling their violent supply rings with payoffs to judges, senators and officers on the beat.

I don’t generally like David Brooks, but he has written some commentary recently that really hit home regarding the Call Out Culture and Social Justice Warrior phenomena.

Back at the end 2000 I on a number of “mailing lists” where I found myself being attacked by both TERFs and Trans-Feminists. I was vulnerable at that point and had it not been for a couple of people, one of whom is my spouse I might well have committed suicide.

The Call Out Warriors bear a close resemblance to lynch mobs, too ready to do terrible violence to people chosen as targets. I can’t for the life of me see one iota of difference between them and the MRAs who have targeted certain women for life destroying harassment.

How not to do social change.

A number of months ago, I listened to a podcast that has haunted me since — because it captures something essential about our culture warrior moment. It was from NPR’s always excellent “Invisibilia” series and it was about a woman named Emily.

Emily was a member of the hard-core punk music scene in Richmond, Va. One day, when she was nearly 30, she was in a van with her best friend, who was part of a prominent band. They were heading to a gig in Florida when the venue called to cancel their appearance. A woman had accused Emily’s best friend of sending her an unwelcome sexually explicit photograph.

His bandmates immediately dismissed her allegations. But inwardly Emily seethed. Upon returning to Richmond, she wrote a Facebook post denouncing her best friend as an abuser. “I disown everything he has done. I do not think it’s O.K. … I believe women.”

The post worked. He ended up leaving the band and disappeared from the punk scene. Emily heard rumors that he’d been fired from his job, kicked out of his apartment, had moved to a new city and was not doing well. Emily never spoke with him again.

Meanwhile, she was fronting her own band. But in October 2016, she, too, got called out. In high school, roughly a decade before, someone had posted a nude photo of a female student. Emily replied with an emoji making fun of the girl. This was part of a wider pattern of her high school cyberbullying.

A post denouncing Emily also went viral. She, too, was the object of nationwide group hate. She was banned from the punk scene. She didn’t leave the house for what felt like months. Her friends dropped her. She was scared, traumatized and alone. She tried to vanish.

“It’s entirely my life,” she told “Invisibilia” tearfully. “Like, this is everything to me. And it’s all just, like, done and over.”

But she accepted the legitimacy of the call-out process. If she was called out it must mean she deserved to be rendered into a nonperson: “I don’t know what to think of myself other than, like, I am so sorry. And I do feel like a monster.”

The guy who called out Emily is named Herbert. He told “Invisibilia” that calling her out gave him a rush of pleasure, like an orgasm. He was asked if he cared about the pain Emily endured. “No, I don’t care,” he replied. “I don’t care because it’s obviously something you deserve, and it’s something that’s been coming. … I literally do not care about what happens to you after the situation. I don’t care if she’s dead, alive, whatever.”

When the interviewer, Hanna Rosin, showed skepticism, he revealed that he, too, was a victim. His father beat him throughout his childhood.

In this small story, we see something of the maladies that shape our brutal cultural moment. You see how zealotry is often fueled by people working out their psychological wounds. You see that when denunciation is done through social media, you can destroy people without even knowing them. There’s no personal connection that allows apology and forgiveness.

A new study shows that gender-nonconforming kids who go on to transition already have a strong sense of their true identity—one that differs from their assigned gender.

Since 2013, Kristina Olson, a psychologist at the University of Washington, has been running a large, long-term study to track the health and well-being of transgender children—those who identify as a different gender from the one they were assigned at birth. Since the study’s launch, Olson has also heard from the parents of gender-nonconforming kids, who consistently defy gender stereotypes but have not socially transitioned. They might include boys who like wearing dresses or girls who play with trucks, but who have not, for example, changed the pronouns they use. Those parents asked whether their children could participate in the study. Olson agreed.

After a while, she realized that she had inadvertently recruited a sizable group of 85 gender-nonconforming participants, ages 3 to 12. And as she kept in touch with the families over the years, she learned that some of those children eventually transitioned. “Enough of them were doing it that we had this unique opportunity to look back at our data to see whether the kids who went on to transition were different to those who didn’t,” Olson says.

By studying the 85 gender-nonconforming children she recruited, her team has now shown, in two separate ways, that those who go on to transition do so because they already have a strong sense of their identity.

This is a topic for which long-term data are scarce. And as transgender identities have gained more social acceptance, more parents are faced with questions about whether and how to support their young gender-nonconforming children.

“There’s a lot of public writing focused on the idea that we have no idea which of these gender-nonconforming kids will or will not eventually identify as trans,” says Olson. And if only small proportions do, as some studies have suggested, the argument goes that “they shouldn’t be transitioning.” She disputes that idea. “Our study suggests that it’s not random,” she says. “We can’t say this kid will be trans and this one won’t be, but it’s not that we have no idea!”

“This study provides further credence to guidance that practitioners and other professionals should affirm—rather than question—a child’s assertion of their gender, particularly for those who more strongly identify with their gender,” says Russell Toomey from the University of Arizona, who studies LGBTQ youth and is himself transgender.

(A brief note on terms, since there’s a lot of confusion about them: Some people think that kids who show any kind of gender nonconformity are transgender, while others equate the term with medical treatments such as hormone blockers or reassignment surgeries. Neither definition is right, and medical interventions aren’t even in the cards for young children of the age Olson studied. That’s why, in her study, she uses pronouns as the centerpiece marker of a social transition. Changing them is a significant statement of identity and is often accompanied by a change in hairstyle, clothing, and even names.)

In 2012, during one of Israel’s periodic wars with Hamas in Gaza, Ilhan Omar, at the time a 32-year-old nutrition coordinator with the Minnesota Department of Education, tweeted the following: “Israel has hypnotized the world, may Allah awaken the people and help them see the evil doings of Israel. #Gaza #Palestine #Israel”

The sentence has dogged Ms. Omar, a refugee from Somalia who last year became one of the first Muslim women elected to Congress and was just seated on the influential House Foreign Affairs Committee. On Thursday, CNN’s Poppy Harlow pressed her again: “I wonder just what your message is this morning as the first on our Game Changer series to Jewish-Americans who find that deeply offensive.”

“That’s a really regrettable way of expressing that,” Ms. Omar said of the anchor’s question. “I don’t know how my comments would be offensive to Jewish Americans. My comments precisely are addressing what was happening during the Gaza War and I’m clearly speaking about the way the Israeli regime was conducting itself in that war.”

Perhaps Ms. Omar is sincerely befuddled and not simply deflecting. Because sentiments like these, once beyond the pale of our public discourse, are being heard with greater frequency and volume these days, allow me to explain why this Jewish American, and almost every Jewish American I know, found her words so offensive.

The conspiracy theory of the Jew as the hypnotic conspirator, the duplicitous manipulator, the sinister puppeteer is one with ancient roots and a bloody history. In the New Testament, it is a small band of Jews who get Rome — then the greatest power in the world — to do their bidding by killing Christ. Pontius Pilate, the Roman governor, speaks to the Jews about Jesus in the book of John: “Take him yourselves and judge him according to your own law.” But the Jews punt the decision back to Pilate: “We are not permitted to put anyone to death.” And so Pilate does the deed on their behalf. In the book of Matthew, the implications of this manipulation are spelled out: “His blood is on us and our children,” the Jews say — a line that has been so historically destructive that even Mel Gibson cut it from his “Passion of the Christ.”

In the two millenniums that followed, even after 1965, when the Catholic Church formally disavowed the belief that the Jews killed Jesus, this was the template for the anti-Semitic conspiracy: the ability of this tiny minority to use its wiles and its proximity to power to con others into accomplishing their evil ends. It has led to countless expulsions, murders, massacres and pogroms throughout Europe and elsewhere.

The Jewish power to hypnotize the world, as Ms. Omar put it, is the plot of Jud Süss — the most successful Nazi film ever made. In the film, produced by Joseph Goebbels himself, Josef Süss Oppenheimer, an 18th-century religious Jew, emerges from the ghetto, makes himself over as an assimilated man, and rises to become the treasurer to the Duke of Württemberg. Silly duke: Allowing a single Jew into his city leads to death and destruction.

The justices chose not to protect the rights of transgender patriots like me.

Brynn Tannehill<Jan. 22, 2019

On Tuesday, the Supreme Court ruled, 5-4, that the Trump administration could reinstate its policy barring most transgender people from serving in the military while several cases challenging the policy are being decided. The decision was both a devastating blow to me personally, and a disturbing sign of what is to come for transgender people in the United States.

I graduated from the United States Naval Academy in 1997, and was on active duty for over a decade. When I began transitioning in 2010, I transferred from the Naval Reserves, which I had joined in 2008, to the Individual Ready Reserves, an administrative status that allows service members to deal with medical issues before returning to full duty. By spring 2012, I had resolved the “issues” at my own expense, and was ready to return to full duty — in my case, as a Navy helicopter pilot.

The problem was that at the time, the military’s medical regulations prohibited transgender people from serving. I then set off on years of volunteer work on my own time researching transgender military issues. This included educational outreach, research, policy development and coordinating with the Pentagon to build an evidence-based standard for transgender service, based on the lessons learned from the other 18 countries that allow transgender people to serve.

In 2015, the Department of Defense stopped discharging people for being transgender and began the open and transparent process of researching how to institute an inclusive policy. This included an assessment of the costs, in terms of both money and readiness, of integrating transgender troops. Researchers found both impacts to be negligible.

By 2016, a policy was in place for transgender people already serving. Two years later, the military put in place a process for new recruits, officer candidates and people on inactive status like myself. The day after that, I contacted my recruiter to begin the process of rejoining the military.

Over the past year, I’ve had countless medical and psychological exams in my quest to return to the job I was trained to do: flying Blackhawk helicopters. This involved a lot of time off work and considerable travel, all at my own expense. At every turn, the people examining me reached the same conclusion: I was “aeromedically adapted” — fit to fly — and able to return to the service. There was, finally, a chance that I might be able finish my career after 16 good years of service.

I was hoping against hope, throughout this process, that I’d be able to join my friends who had fought alongside me for the right to serve openly. Nearly every week I would see pictures of them in Syria, Iraq and Afghanistan. It gave me a thrill in December to see a picture of four of them together at Bagram Air Base in Afghanistan. One was an airborne ranger, and one was Special Forces.
All of this makes the administration’s dogged attempt to undo everything achieved over the last few years even more baffling. The ban was developed in secret, without the sort of careful study that went into the policy it reversed. It does not reflect any current medical understanding of transgender people, and it has been denounced by the American Medical Association, the American Psychological Association and the American Psychiatric Association.